国产JASPER弹簧圈栓塞治疗颅内动脉瘤的临床观察

Endovascular treatment of intracranial aneurysms with JASPER electrolytically detachable coils: a clinical observation

目的比较国产JASPER颅内可电解脱弹簧圈和进口电解可脱性铂弹簧圈栓塞颅内动脉瘤的临床效果。方法 62例颅内动脉瘤患者分别以JASPER(30例,JASPER组)或进口弹簧圈(32例,对照组)行颅内动脉瘤栓塞治疗。由同一术者使用同种微导管进行血管内栓塞治疗,术中观察2种弹簧圈在X线下的可视性、在推送中的顺滑程度、解旋情况、软硬程度、成篮效果、致密填塞情况及解脱时问。采用电话、门诊及数字减影血管造影(DSA)进行随访。结果 JASPER组共用JASPER弹簧圈95枚,对照组用圈108枚。在微导管中推送弹簧圈时,JASPER组有8枚欠顺滑,对照组均顺滑;在反复推拉弹簧圈时,JASPER组有5枚发生解旋,对照组有1枚解旋;JASPER组平均电解脱时间为45 s,假解脱5次,对照组平均电解脱时间为1 s,假解脱3次。2组的致密填塞、瘤颈残留和不完全填塞的比例差异无显著统计学意义。随访3～22个月,未再出血;48例术后DSA随访,2组中各1例复发。结论 JASPER弹簧圈栓塞颅内动脉瘤是安全有效的。

Objective To compare the effectiveness of the JASPER electrolytically detachable coil and Platinum coil system for embolization of intracranial aneurysms.Methods Sixty-two patients with intracranial aneurysms were treated by JASPER coils(30 patients,the JASPER group) or by MicroVention coils(32 patients,the control group) for the embolization of aneurysms.All procedures were operated by the same surgeon with same type of microcatheter.The visibility of both coils,easiness of deployment through microcatheter,uncoiling,flexibility,effect of forming a basket,dense packing,and the time needed for detachment were observed under the fluoroscopy during the procedures.The patients were followed up by telephone,outpatient appointment,and angiography.Results A total of 95 JASPER coils and 108 MicroVention coils were used.Friction was observed(8/95) in the JASPER group during pushing of the microcatheter,while none was found in the control group.5 coils in the JASPER group and 1 coil in the control group were stretched during the repositioning.Electrolytically detaching time was more than 45 s in the JASPER group but only 1 s in the control group.There was no significant difference between two groups in the percentages of densely packed,neck remnant,and incompletely packed aneurysm.All patients were followed up from 3 to 22 months(mean 7 months),and no rebleeding happened.48 patients were followed up with digital subtraction angiography(DSA),and each group had one recurrence of aneurysm.Conclusion It is safe and effective for treating intracranial aneurysm by JASPER coil.